Is premolar extraction necessary? (Photos)

My Orthodontist suggested removal of 4 premolars before getting braces due to the lack of space in my mouth. But I heard that removal of premolars can make you look aged and cause TMJ issues or sleep apnea. I really want to know if there's any other alternative for me. I want straight teeth but I the idea of removing 4 teeth doesn't sound appealing to me.